Provider Demographics
NPI:1376767004
Name:GHATTAS, NAGY B (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAGY
Middle Name:B
Last Name:GHATTAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13830 WINDWARD HARBOR CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-5013
Mailing Address - Country:US
Mailing Address - Phone:713-440-8488
Mailing Address - Fax:
Practice Address - Street 1:3403 RIVERS EDGE TRL
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2634
Practice Address - Country:US
Practice Address - Phone:281-973-5012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18028122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist